What's The 'Take Home'?

摘要

Clinical and laboratory findings for this patient are typical of alcoholic hepatitis, which is serious but also treatable and reversible.Clinical features of alcoholic hepatitis. This man's case is a compendium of typical features. His age is in the range within which alcoholic hepatitis most commonly presents: 40 to 60 years. He consumes in excess of 100 g of alcohol per day. His symptoms of anorexia and fever, as well as the physical signs of jaundice, tender hepatomegaly, and impending encephalopathy, are also consistent with the diagnosis. Hie laboratory evaluationhas excluded viral hepatitis and biliary obstruction. Finally, his moderately elevated AST level (less than 300 U/L) is more than twice his ALT level; this finding in a heavy drinker indicates alcoholic hepatitis.In cases such as this, a liver biopsy is not needed to make the diagnosis.1 Should a specimen be obtained, the typical histological findings include hepatocyte ballooning, hepatocytes laden with fat droplets, and hepato-cytes that contain amorphous eosinophilic inclusions (Mallory bodies).